You gave a lecture today on the supremacy of the market in the U.S. Tell me
how that affects assisted reproductive technologies [ART], for instance?

American society, to a much greater extreme than any other Western country, has
a sense that the marketplace is all important. Individual freedom is much more
important than issues of society as a whole. So in my lecture today, I
explained why there are absolutely no federal regulations guiding embryo
research or even banning human cloning.

The reason is because on the one side you have religious conservatives who want
to ban all sorts of embryo research as well as abortion. On the other hand, you
have traditional conservatives who are very much against regulation of any
kind. And then you have Democrats who are very much interested in keeping
choice for a woman open. So you have all of these different forces competing
with each other and in the end you end up with no laws at all.

Do you think that there should be laws?

Oh, I think that regulation is important to make sure that these technologies
are used with informed consent and that people aren't harmed. And I would say
that most people would be willing to accept regulations if the regulations were
reasonable, the kind they have in the United Kingdom, for example. But what
most people would say is that no regulation is better than a bad
regulation--regulation that bans everything.

You're a mouse geneticist by training, but you seem to be fascinated by the
assisted reproductive technologies. Why?

I'm fascinated by the way that science interacts with society and the way in
which reproduction--reproductive science--interacts with the way people behave.
[It] is very interesting, because there is a very powerful desire that most
people have to have biological children. So you have this basic science of
reproductive technology, which has been developed over the last 20 years, to
help people who were previously infertile have babies. And you have this clash
of ideas coming into the question of whether or not people should be able to
manipulate embryos, whether or not you should be allowed to have in vitro
fertilization [IVF], select embryos and all of these different kind of
scientific abilities come into play with political concerns. I'm fascinated by
that whole mix.

We've been to a cryobank in California, where we saw people picking sperm
donors, and somebody on the phone describing what a particular person might
look like and how it would match the husband. How do you feel about that?

Well, this is a very interesting case. The only people who are using sperm
donors are people who, for whatever reason, can't have babies the old fashioned
way, where the man cannot produce sperm, the man is sterile. So the sperm donor
is a last result for this couple to have a child that is genetically related to
the mother and not the father. So as a last resort they need to go to a sperm
donor.

What happened in the past, of course, is that the physician would decide who
was the perfect sperm donor. But the American way is very consumer-based and
people have realized that they have the ability to make the decision and that
many people think that they should be the ones who make the decision, not the
physician. Since they have to use a sperm donor, most people in America say,
"Look, I have to use the sperm donor anyway, I might as well be allowed to
choose who that sperm donor is, be allowed to determine the characteristics of
the person ... "

They're choosing for things like height, the shape of the eyes, the color of
the skin, but there are now many ads asking for people with a certain SAT
score, asking for somebody with musical ability. What do you think about that
as a geneticist?

I would say, first, what people want is to have babies that look like
themselves. So most people are going to try to choose a sperm donor which has
the same characteristics as the infertile male member or partner. If they try
to choose other kinds of characteristics like enhanced intelligence and musical
talents, they might be able to play games with probability, but they're not
going to guarantee anything in their child. And I don't know if all people
understand that. That there is no guarantee that the child will have any of the
characteristics, the behavioral characteristics that are present in the sperm
donor.

They're really seeking some kind of genetic determinism here, do you think
that they are confused?

They're overestimating the role that genes play in who we become. It is
perfectly clear that genes do influence what we are and what we become, but
genes are not all that determining. You can be born with all of the musical
talents in the world, but if you don't practice the piano, you're not going to
be a great musician. We're not even at the point to where we can actually see
what genes are going to determine musical talent or not. Most people don't
understand that there is much, much more than genes that play a role in whether
we are successful or whether we live up to our potential.

Why is it that there is such a seeking for this genetic counterpart, this
child of my genetic heritage?

I'm a biologist and I actually believe very firmly that there is a kind of an
instinct that people have to want to have biological children. I don't see any
problem with that. Most people are able to have biological children without any
intervention. And if all they're trying to do is use these technologies to
enable them to have a child with a link, that is perfectly fine. I don't have a
problem with that.

But it's going further than that now. We have sperm donors, we have egg
donors, we have gestational surrogacy ... yet they're still trying to keep this
tenuous, it seems to be, genetic link intact?

Well, actually, when we come to sperm donors and egg donors, they're breaking
the genetic link. They're saying, "I can't have this genetic link. I really
feel bad about that, so I'm going to get the best thing that I can." That is
what is going through their minds. In the first instance, most normal people
would prefer to have this genetic link over anything else. But then they feel
kind of upset. "I can't have the genetic links, I'm going to get the best sperm
donor I can or I'm going to get the best egg donor I can as a last resort, as a
second best opportunity." That is what is happening with the sperm and egg
donors.

Some people think there is a real problem mixing egg donors and sperm donors
... They would actually draw the line after IVF, and would not have donor sperm
and donor eggs used. What do you think about that?

I don't have a problem with use of donor sperm or donor eggs if people want to
have a baby. The most important thing that we have to ask is what is the intent
of the parents? If the intent of the parents is to try to have a healthy child
that they're going to give unconditional love to, then I don't think it matters
where the child was conceived, where the child was gestated.

Also, the other important concern is whether the technology is safe. We want to
make sure that no technology is used unless it's been demonstrated to be
safe--to not cause birth defects, to not cause any harms to the child. But
whatever the technology is, if it gives rise to a child that is loved by the
parents, I think that is good.

There is a problem when you talk about surrogates, because now you're talking
about a woman who is having a baby that she is going to give up whether it's
related to her or not, she is going to give it up to another couple ... there
are biological issues there that a woman feels a certain connection to the baby
that she might not be aware of when she goes into the procedure.

A number of clinicians and some of the best labs in the country say that
there will be pre-genetic diagnosis available and it's being done now. But they
also say that coming along with that will be the iiability to enhance the
genetics in the future. Do you think that is true?

I am absolutely convinced that we will have both an expansion of pre-embryo
genetic diagnosis as well as genetic enhancement of embryos. The reason I'm
sure it's going to happen is because we have already perfected this in animals.
It's something that we do in mice in this building every day. We put new genes
into mouse embryos and the mice grow up with these new genes. So yes, this is
going to happen. It's going to be possible.

Do you have any concerns about that?

Well, my concern is that people are going to be thinking that they are getting
something that they're not getting, perhaps. That is one problem when you're
talking about genes that affect behavior, personality.

The other part of this technology, though, is that parents are going to want to
give their children enhancements in health. That is the way the technology is
going to be used first. For example, 1% of people are naturally resistant to
infection with the virus that causes AIDS, HIV. They have a gene and we
understand how this gene protects these people from being infected by this
virus. So you can imagine prospective parents in the future saying, "I want my
child to have this gene which will protect my child from getting AIDS."

Then it becomes very difficult to say that parents should not be allowed to do
this, because they are giving their child something that some other children
get naturally. And parents will say, "What is wrong with giving my child this
enhancement ... We give all of our children a polio vaccine after birth. What
is wrong with the genetic vaccine against AIDS?" When you are thinking about it
from the individual level, it's very difficult to find something that is wrong
with it.

I would say the difference between the polio vaccine and a genetic vaccine
against AIDS or any other kind of disease is that the polio vaccine is given to
all children in the country. There is no difference in accessibility. Whereas,
this genetic enhancement technology may only be available to those who have
money and so my concern is for those who are not able to receive this
technology. They will be at a disadvantage.

If we enhance for something like the health issues, which surely may happen,
we can then enhance for other issues as with the human genome project, and that
is a great concern for people.

The interesting thing about genetic technology is that once the technology has
been perfected, it's the same technology no matter what genes you want to put
in. So if you develop the technology for putting in genes that enhance health
characteristics, then that very same technology can be put in to give a child
other kinds of non-health characteristics like increased talents, which we'll
be able to figure out some day or increase memory abilities or cognitive
skills.

Now, of course, we have to remember that none of these genetic enhancements of
personality behavior or cognitive abilities are going to guarantee anything in
the child. They are just going to increase probability that the child will have
this talent or disability ... we also have to understand that the way this is
going to work is that parents are going to give their children something that
other children get naturally ... they're going to say to those who want to
prevent them from getting this technology, "Why can't I give this to my child
when other children get it naturally?" That is the argument that they're going
to use and it's a very powerful argument in our society, where we basically
allow parents with money to give their children environmental advantages that
other children don't get.

We already have a group of people that are going through assisted
reproductive technologies who are largely white, largely better off than other
people and it already is a somewhat of a class system. You can see it in the
waiting rooms. Is that one of your concerns as this marches on?

Yes, I think that this is basically unfair. But what I would like to point out
is that it is completely analogous to what we already do. It costs $120,000 for
parents to send their children to Princeton University. If a child comes from a
middle class family they're not going to get a scholarship, they are not going
to be able to afford to come to Princeton University.

Our society accepts this unfairness, and so what we're doing is we're taking
this basic principle upon which our society operates, a basic marketplace
mentality--if you have the money, you can do it. We're bringing this down to
reproduction and we just keep pushing and pushing and pushing. I think that
it's all unfair. It's going to make even worse the division between the have's
and the have-not's in our society.

Some of the most cogent thinkers from the religious community will say, "to
some extent, this creation of a child is a creation that we can't control. It
is full of a kind of a mystery." What do you say to that?

Well, 200 years ago, most people thought that it was wrong and immoral to cheat
death. The vast majority of people in Europe said, "If it's time to die, then
God wants you to die, and you should die. You shouldn't do anything to stop
that." That is not the way we think today. Every time we use medicine to cure a
disease or prevent death, we are going against nature. And most people do it
gladly because they want to live longer.

So yes, in the past we had to accept a random roulette of what genes went into
our children, but that is not a valid reason to say that we shouldn't go and
select genes. There are other reasons that we should be worried, but not the
fact that because in the past it was random, we should continue to make it
random.

Well, we're not talking only about randomness here and we're not talking,
really, about disease, in the classical sense of disease. We're talking about
the creation of life outside of the human body.

Yes.

... That kind of opinion needs to be respected to some extent.

Well, many different people have different religious points of view. There are
some very religious people who are perfectly willing to accept in vitro
fertilization and other technologies if it brings no harm to the prospective
parents, and it brings no harm to the baby. Most Jewish groups are willing to
accept that. They think it is good to assist people to have babies that are
going to be loved. So there is not universal religious point of view on
manipulating embryos ...

So you have really no concerns with that part of the argument?

My concern with the technology is not that it is unnatural or that we shouldn't
be creating embryos in culture. My concern is that it's being done in a way
where the parents are aware of the risks, where the physicians are only using
technologies which have been proven to be safe through animal experimentation.
My other concern is that technology is more freely available to more people in
society.

Let's talk about one of the risks that most clinicians agree with--the risk
of multiple births ... A clinician said to us, "I can talk about prematurity
until I'm blue in the face." Indeed, most infertility clinics don't actually do
that, but they talk about the risk of multiple births.

The reality to a patient who then has a multiple birth with children that are
born, let's say, 25 or 26 weeks and they are struggling for life, is very, very
different for them. For the doctor then to say, "Well, I gave them informed
consent. I told them about multiple births." This is where one has to think
really carefully about this informed consent issue, because people come with a
certain sense of what information they take in and what information they
don't.

With in vitro fertilization the doctor can determine how many embryos he's
going to put back into the woman. There are some physicians who won't put back
more than two embryos ... you can only get twins. There is more of a problem
with multiple births when using fertility drugs, which is less of a high
technology than in vitro fertilization.

With in vitro fertilization you can control the situation much better. So
physicians might ethically decide that they're not going to put back two
embryos. That is one way that you could go. The other way to go is to say,
"I'll put back three embryos," which is really the most that physicians do
right now and say to the couple, "I'm putting back three embryos as long as you
will tell me that if all three take and there are three embryos in your uterus
that you're willing to reduce. That you're willing to abort one of these or two
of these embryos to insure that the one or two that are left are more likely to
go full term."

I have no problem with an early abortion, and if people are willing to accept
that, that is another way to get around this problem. But I agree that none of
these are perfect solutions.

You predicted, I think two years ago, that human cloning would be here with
us, within two years.

I don't think I said that ... I predicted that human cloning would be with us
in 10 years and I still believe that is the case, because there is a demand
among a small number of people for this technology to have babies. It's being
driven by the marketplace. I think that, ethically, one should not use this
technology until they are convinced that it is safe and efficient, shown with
the use of animals. But I don't think that physicians around the world are
going to wait for the confirmation that it's safe and efficient in animals.

The best example I can give you why physicians are not going to wait as they
should is with ICSI, an intracytoplasmic sperm injection. This was a new
technology developed in the early 1990s to overcome severe infertility and
physicians did not wait to prove that it wasn't going to cause birth defects
before they embraced it wholly across the country. We can use that history to
understand how cloning is going to go. I'm not advocating the use of cloning in
this way. I think it is wrong, but it's going to happen.

Can you explain simply what cloning is, because [some] people think that
it's the creation of an adult copy.

When biologists use the term cloning, they mean something very different than
what the public views cloning as. In the case of Dolly, what happened is the
genetic material was taken from an adult cell and that genetic material was
placed into an egg whose own genetic material had been removed. Under the right
conditions, that egg with a complete set of genes, with a complete genomic
material, could develop into an embryo. It would divide into multiple cells and
that embryo could be placed back into a uterus to develop into a fetus and
ultimately into a baby.

What would happen in those relationships?

Well, in purely genetic terms, if a woman used this procedure to have a baby,
the child, the daughter would actually be the genetic sister of the mother. But
I don't think that the mother would treat the child as a sister. The social
situation would make the mother treat the child as a daughter ... we already
have confused examples of heritage right now. If a person's father has an
identical twin brother, then that person's uncle is also their genetic father
in purely genetic terms. So we don't look at things in purely genetic terms. We
look at things most often in social terms.

We have these confused identities and new forms of family, but we don't
deliberately create them very often. In this instance, we are creating them and
we are creating them within a private, market-driven industry.

When it comes to cloning, people are over emphasizing the genes ... the genes
are being blown out of proportion. The reason is because every day somewhere in
the world there are children born who look just like one parent and who grow up
and behave just like one parent.

A clone will be no different than children who are already born today. It will
pretty much look like one parent and it will have many of the same behavior
predispositions as the one parent. But that already happens, so nobody is going
got be able to distinguish a cloned child from a child who happens to look and
behave like one parent.

Do you think that the people who are proponents of using this new
technology, that see some real excitement in it, and see some possibilities in
it, will actually develop a new language for it?

... ultimately, when children are born with the use of this technology they
will not be called clones. There is a technology that scientists developed
called nuclear magnetic resonance. When this was used in medical scenarios,
people were resistant to it, because the word "nuclear" was there. So we
changed the name of the technology to MRI [magnetic resonance imaging] and now
everybody accepts it. The same thing is going to be happening with the so
called cloning technology. It's going to be called single parent children or
some other innocuous phrase that is going to be used.

...

[Do you think] there is something of a "yikes" factor?

We know from history that the "yikes" factor can often be misleading. In 1978,
when the first baby was born by in vitro fertilization, most people were
horrified. The vast majority of Americans, when asked, said that they would
never consider the use of in vitro fertilization even if they were infertile,
because they didn't understand what the technology did. It was an alien
technology. It made them afraid. Today, of course, IVF is an acceptable
practice across the country and most infertile people would consider trying to
use IVF if they could.

Can you tell me where this new technology will emerge from?

Cloning is certainly going to emerge from the fertility clinics that exist in
this country and elsewhere around the world, because it's only in the fertility
clinics where the technology exists from taking eggs out of a woman's ovary,
developing the eggs in a petri dish and putting the embryos back into a woman's
uterus. That is done at fertility clinics. It is not done at biotech companies
or anywhere else. So when cloning happens it's definitely going to happen
within the context of a fertility clinic.

So even if 99% of them say no, all it takes is one clinic somewhere to not talk
about it and just to use the technology to give rise to children who are going
to be genetically identical to one parent.

Do you think that there is something coy or slightly political about them
saying no?

Oh, it's absolutely political. Fertility treatments are highly controversial in
this country. One of the things that president Harold Shapiro, president of
this university, and who is also the head of the national bioethics advisory
commission, told me is that when they had hearings on human cloning in the
United States about a year or two ago, he invited a whole series of fertility
doctors to come testify, and they all refused. They are a profit making
business. They're in the business of trying to help infertile couples have
babies, and they have no reason to publicize themselves.

You know what the critics say about children as commodities, as products, as
designer babies. What do you say to this ...

I don't think that these people who claim that we are commodifying babies have
ever actually talked to any couple who has had a child by one of these assisted
reproductive technologies. The vast majority of these couples desperately want
to have children and they treat their children as children.

This word cloning, indeed, the practice as you see it on the horizon, does
not greatly dismay you?

I am not dismayed by cloning, because I don't think that it's going to be used
in all of the outrageous kinds of ways that people have thought up, like the
egomaniac, for example, that wants to have a replica of him. Cloning does not
achieve immortality. What the ego maniac will end up with is a baby that will
kind of looked like he looked like a baby that will grow up into a boy that
won't listen to him. So he's not going to get what he expected. He's not going
to achieve immortality. He's just going to have a son. He's not going to be
able to control the life of that son. When people understand the little that
cloning does, most of these kinds of people will lose interest in the
technology. It's not going to accomplish what they think it's going to
accomplish.

So you may ask me, "Then why would anybody use it if you're not going to be
able to guarantee the child is going to turn out in a particular way?" My
answer is that the only people who will end up really using this are people who
can't have biological children another way and are going to be using this to
have biologically children, because what most normal people want is
unpredictable biological children. They want this genetic link to their
children. And if that's why they're doing it, not expecting anything except to
have a child that may not listen to them, that I don't have a problem with that
use of the technology.

You have raised the issue before about creating Madonnas, Michael Jordans
and the critics say that is indeed what will happen. At first, one can dismiss
that argument very quickly. But when you see how market driven this culture is,
how many groupies swarm around people like Madonna, clasping at her clothes, at
her hair ... it gives you pause, really ...

Well, the question I have for people who worry about this star being cloned is
to say to them, how often do you think a movie star has donated their sperm or
eggs to a sperm bank today? I think the answer is none of them have put their
sperm into a sperm bank. They're not interested in getting the $70 back to put
their sperm or to donate their eggs, which is a serious protocol, into a bank
...

One of the issues that I raise in my book is that it might be done
surreptitiously. That somebody will come up and take a scraping from Michael
Jordan's skin and use that scraping to have a clone. I don't know how realistic
that is. But I don't think it's very realistic, because the child that comes
out of that cell, even though that child will be genetically identical to
Michael Jordan, I can guarantee you that there is no way that child will ever
make it into the NBA. Because Michael Jordan is more than his genes. Michael
Jordan worked very, very hard and it was this hard work and this spirit that
allowed him to reach the point that he reached. People forget that genes
provide a framework and the potential, but unless you work very, very hard
you're not going to get anywhere without it.

You talk in your book about an elite class of people called the "gen-rich"
and then the other group of people that are called the "naturals." That is
actually where you're thinking is leading, to some extent, and what gives you
some concern.

My great concern is that genetic enhancements, although they don't guarantee
anything, really will widen the gap between the have's and the have-not's. I
put a very speculative argument into my book that said that people who have
money in society will give genetic enhancements to their children. Their
children will take those genetic enhancements and automatically give them to
their children and add extra ones in. And that generation after generation
after generation of accumulating these genetic enhancements could lead to a
group of people who were genetically distinct from the naturals who are us.

That is the one point in my book that I've had serious argument from
biologists, who say to me that it will never be. There will never be a point
where humans actually don't have relationships with each other, and that
because people who are genetically enhanced will always be having relationships
with people who are not enhanced, that there will never be the separation of
species. That, in fact, there will be an extension of the group who have
genetic enhancements. We won't get these two species. I agree that that may be
the case. I don't think that we can know without going into the future a
thousand years ...

Can you describe where this technology could go that concerns you?

The most disturbing part of this technology is not the cloning, where you just
have a child born who happens to be related to one parent instead of two. The
most disturbing part of this technology is when parents are going to try to use
genes to provide their children with serious advantages.

Now the problem is that all parents want to give their children advantages. In
the United States, we have a market-based mentality, where we say that parents
who have money can give their children more advantages than parents who don't
have money. We all accept that. I think parents are going to keep going back to
the genes and say, "I want to give my child every possible genetic advantage in
the book."

That is troubling to me, for two reasons. One is that some of these genes
really will provide advantages. Advantages of longevity, decreased risks of
cancer and stroke and dementia, and so these children really will have health
advantages, which means that the parents who are unable to afford this
technology will have children who are disadvantaged. So I see this as greatly
exacerbating the gap between have's and have-not's--much, much greater than it
is today. That concerns me.

The other thing that concerns me is that parents will be giving their children
genetic enhancements that they think are going to increase the behavioral,
cognitive or talents of their children. And many times, they're going to be
disappointed. It doesn't mean to say that the genes won't increase the
probability that their child will have a particular talent, once we understand
how genes affect talents, we don't yet. But I think that parents may be getting
into this not realizing that all they're doing is increasing probabilities.
You're not going to guarantee anything. So you worry about how parents are
going to feel about children who don't express the genes that they got.

But isn't there something to be said for the position of people who say, "We
do get, in some ways, the luck of the draw, we do get a surprise when we have a
child? This is in the nature of something that we can't control very well and
we want to take it into more of our control." There is a sense of determinism
in this where you see people at computers picking the sperm donor.

I reject the luck of the draw argument against the use of the technology,
because it was the same argument that people used against medicine 200 years
ago. People said, "Well, some people get infected and die and other people
don't and that is just the way it is. That is the way God intended it to
be."

Now we reject that notion. We use medicine to overcome the unlucky draw. I
don't understand why we should stop people from wanting to use medicine at an
earlier time. In other words, I don't see why it is problematic for parents to
want to give their children health advantages, because after birth they provide
all sorts of advantages to their children. Before birth, they're going to want
to do the same thing. The problem that I have is the access issue that some
people are going to be able to give their children advantages that other
children don't get. But I don't think the luck of the draw issue is going to
ring true with people once this technology becomes available.

Well, maybe I didn't use the right phrase, but that sense of surprise, that
sense of uncontrollable. There being some kind of romance or mystery about
this?

There are two ways to answer this question about the luck of the draw. The
first is that it's always going to be uncontrollable. The child's always going
to be a surprise no matter what. No matter how much we know about the genes,
the child is going to come out and be unpredictable. That is always going to be
the case ... We don't ever get to the point where we're going to be able to
control everything, because genes just provide the framework, not everything
else.

Now, beyond that, the question is: Does this surprise? And it's good to have a
surprise. I think that should be up to the parents. Some parents choose to know
what the sex of their child is while the woman is pregnant and some parents
choose not. The parents who choose not say they want to be surprised at birth.
The parents who decide to find out the sex of their child, say, "I don't care
about the surprise; I want to know." So we have to respect the individuals
difference in the notion of whether surprise is good. Because, as I said, there
is always going to be unpredictability in a child. So we don't have to worry
about that.

What about the sense of a child's own lineage ... there isn't a clear
genetic lineage for many of these children ...

I think that this notion of genetic lineage ... it's belied by what already
happens in society today. Adoption is accepted. Children who are adopted treat
their adoptive parents as a mother and father, there is no lineage there.
Sometimes they do have the instinct to go back and look at their lineage. But
cloned children could do the same things as well. When it comes to genetic
engineering, the lineage is still going to exist. The social condition and the
social relationships between children and parent are more important to the
rearing process than the genetic relationships.

They may say that the social relationships are important too, but the
genetic ones are also important. Surely, we see the adopted child searching out
their birth parents. There are very few records of sperm donors and egg donors.
In fact, in this area of the country, most of the donors are anonymous.

I don't think that this is a reason to stop people from using these
technologies and having babies. I mean, we don't stop people from adopting
children. We say, "Oh well, that's done for the good of the child." It is
perfectly allowable for parents to use this technology because maybe the
children will grow up and say, "Well, where did I come from?" Hopefully, we'll
have regulations which will allow the child, when a child reaches a certain
age, to go and look for the genetic parent that the child never knew. With
cloning there is not an issue. With cloning it will be perfectly clear what the
genetic lineage is. So I don't see why that is problematic.

As a scientist, is it possible that this generation of children, that have
grown up since IVF was discovered in 1978, will have something wrong with their
reproductive systems because of these kind of drugs that largely their mothers
took?

What's going to happen, unfortunately, is that children who are conceived with
advanced reproductive technology are going to have a higher probability of
being infertile just because there is a genetic component to infertility. So
the rate of infertility is certainly going to increase in the future. I can
tell you that as the population geneticist from that kind of perspective. That
is certainly problematic.

What effect the hormones will have, I don't know. We know that DES causes
severe problems in the woman. The hormonal levels being used right now are much
less than what was used with DES. But there will certainly be an increase in
the rate of infertility among these children so that you're going to promulgate
this technology, it's going to have to be used generation after generation.
That is frightening.

Why is it frightening?

It's frightening because on the one hand, you're doing something good for
people by allowing them to have children they're going to love. On the other
hand you're increasing a kind of a disease, which is infertility, and so these
children are going to be born with this new disease. So you have these
tradeoffs. I find it very difficult to deal with these tradeoffs when they
clash against each other like this.

We have a couple in this FRONTLINE report where the man has Kartagener's
syndrome. It's not able to be tested for. They decided they would go ahead and
have a child and they have a child who seems to be a healthy child, but they
took a gamble. What do you think of that?

I believe that people should be able to reproduce. There are all sorts of
people out there who have family histories of heart disease and family
histories of cancer and we know that their children will have an increased risk
of cancer or heart disease and we don't stop those people from reproducing. I
don't see how we can stop people who have diseases from reproducing, especially
when they're not sure what is going to happen to the child.

It would unethical to have a child who is going to have a serious disease
knowing the child is going to have a serious disease. But in these situations,
really there is no way of knowing what is going to be happening for the child
and one just hopes the child will be normal and healthy and one hopes that if a
child is not healthy that there'll be some kind of medicine that the child can
use to become healthy.

... a bioethicist said to us today that nobody really is speaking about the
child and the child's rights. They are talking always about the couple, the
desperate couple's need for a child, but they are not talking about the
children's rights ...

It is unethical to use the technology which has a high chance of causing harm
to a child to be. I would agree that that would be unethical. But that is not
what is happening in most of these cases. Most of these cases, it's not clear
what the technology is doing and in most cases the technology is going to give
rise to children who are healthy. You can't take a child's rights into
consideration when the child doesn't exist.

I would say to these people who say, "We have to think about the child, not the
infertile couple," that if these people were really being logical they would
stop parents or prospective parents who have serious diseases which will
definitely be transmitted to their children the old fashioned way. They need to
stop those people from having babies, and nobody would do it.

So if we don't stop people from having babies the old fashioned way, no matter
what, as well the parents are not criminals. I don't see how we can stop
parents from using advanced reproductive technologies to have babies.

They would say that there can be a regulatory environment, because you're
actually creating life, you're bypassing natural barriers. It's a completely
different thing than natural or sexual reproduction in the general society.

I don't believe in the meaning of the word natural. I don't think that natural
is good. Natural brings us AIDS, natural brings us polio. We go against nature
all of the time. So I don't think we should put natural onto a pedestal and
that is not the reason that we should regulate reproductive technologies
different than we regulate whether or not fertile people can have babies.

We have to regulate the technologies so that no harm is caused, so that the
technologies are not being used before they're shown to be as safe as natural
childbirth. Which, by the way, is not very safe. It causes a lot of women who
have natural childbirth have problems during childbirth and there is a rate of
birth defects in the order of 2-5%. So doing it the old fashioned way is not so
safe either. A new technology should be at least as safe as the old fashioned
way, before it should be allowed to be used.

What sort of regulations do you see? Would you support certain regulations?

I would support the regulation basically saying that this technology, that new
reproductive technologies must be treated the way all technologies are treated,
all medical technologies are treated, which is it has to be validated in
animals. There has to be some kind of scientific understanding that the
technology is not going to bring harm to the child. That's the limit of the
regulation that I would put onto it.

But that's not been the nature of how this has grown up?

Well, this is not going to happen, because what happens in the political arena
of our country is that if you try to put what I consider to be sensible
regulations on the use of this technology, those regulations get hijacked by
people who want to ban the use of the technology and we fertility doctors know
this. And what fertility doctors will say to you, is bad regulations are much
worse than no regulations at all.

The human embryo research ban, has that been something that has really hurt?

I don't think the human embryo research ban has actually hurt anybody, because
there is no ban on human embryo research in private clinics. The ban is on the
use of federal funds to do human embryo research. The scientists who work in
the federal laboratories, the federally funded laboratories, want to jump into
this game and want to get this money to do their research. They are the only
ones being harmed by this ban.

So it hasn't had the effect of no oversight because no National Institute of
Health money involved?

That is exactly what has happened with the ban on the use of federal funds for
embryo research. What has happened because of that ban is that all of the
research gets pushed into private clinics and private laboratories where there
is no regulation, and so the people are willing to take much more risks. They
are willing to push the envelope much further in these private clinics. If we
had some kind of regulation, the research would be going forward much more
slowly.

What do you think of that?

Well, I don't have a problem with the research going more slowly. I really
believe that we have to make sure that the research goes along in an ethical
way. But I can tell you that because of the political situation in the United
States, it seems clear to me that we cannot get sensible regulation. That there
is a religious conservative group that will hijack that regulation and make it
much more severe than most physicians want it to be.

Are there any other issues which we haven't covered?

The main issue in my mind--this is very powerful technology. For the most part,
parents don't want to use this technology to harm anybody. This technology will
be used by prospective parents who want to help their children. Help their
children be more successful, help their children be healthier, healthier
children perhaps be better to do things in the world. That is the way the
technology is going to be used.

What I see is the problem is really conflict between liberty and justice. On
the one hand, people should have the liberty, which we care a lot about in this
country, to be able to do things to help their children. On the other hand,
this technology is so powerful that if we leave it in the hands of the
marketplace, the parents who don't get to use it will have their children at a
disadvantage.

You talked about these as a very powerful technologies ... Does this give
you cause for concern, the place we find ourselves in now, as our tools become
so powerful?

I am always amazed and surprised by the power of biotechnology, especially as
it is being applied to human beings, and how it will be applied in the future.
This is a revolutionary, evolutionary point in our history as a species. I
really believe, very strongly, that our species will change. If it doesn't
happen in 10 years or 50 years, it will certainly happen within the next 100 or
1,000 years. So it gives us pause that we have taken control over our own
evolution as a species. We have no idea of where we are going to end up. But
we're going to control our evolution--not nature, not the environment. We are
going to control the evolution of our species.

On one hand, that is just absolutely fantastic and amazing. On the other hand
one really worries about our species dividing among classes and groups. So I'm
very ambivalent about this technology. I'm excited about it on the one hand and
I'm frightened to death on the other.

I would say not only that, but how dare we?

As I told my class, we've been practicing genetic engineering on animals for
the last 10,000 years. Genetic engineering is the foundation of civilization.
We have engineered pigs out of wild boars. Pigs are not natural. Cows are not
natural. Corn was invented by the Indians. They engineered, the old fashioned
way, a weed to become corn. So we have been taking control over nature for a
very long time.

In the last 100 years, we have been taking control of our own bodies as we use
medicines to overcome disease, as we use heart transplants to cheat death. So
we are already doing it. It's just that this is an exponential process. And
take everything that we've done already, which is really amazing, it's going to
pale in comparison to what we can do in the future.

By that you mean the world of IVF and assisted reproductive technologies as
well as cloning?

There are so many new ways in which we're able to manipulate reproduction that
were unthinkable 20 years ago. We can already see ways in the future where
we're going to be able to manipulate and control the genes that we give to our
children. It's just over the horizon. So all of these new technologies are
going to change humankind as we know it.